Title

Abstract

Abstract Category: Practice Innovation / Performance Improvement (PI)

Purpose: The purpose of this initiative was to review the Patient Discharge Follow-Up Call (PDFC) Data, point out its importance and identify the issues presented in order to bring awareness to key stakeholders and continue to monitor the impact on patient outcomes.

Methods: In mid-February of 2018, based on the collected PDFC Data, the PI Director, PI Coordinator, Statistician and Quality Assurance Nurse (QAN) identified opportunities to educate Nursing, Hospitalists, Pharmacy, and Leadership on the issues related to discharge medications potentially leading to a return visit to the Emergency Department (ED), possible readmission and adverse patient outcomes. In early March of 2018, this team presented information for awareness purposes, gathered an Interdisciplinary team to review data and worked on opportunities.

Findings: All patients discharged from West Kendall Baptist Hospital (WKBH) receive a follow-up phone call from the QAN within 24-48 hours. Out of the 3,897 PDFC in the period of September 2017-February 2018 approximately 70% of patients were reached. Of those patients that reported issues (2.7%), the majority (63%) reported issues related to discharge medications.

Discussion: In as much as the majority of the patients reported no issues, the small percentage who had problems with medications related to prescribing warranted an intervention to prevent possible readmissions and reduce adverse patient outcomes. The team decided to address the medication issues by implementing the following:

Address verification of accuracy of preferred pharmacy during Interdisciplinary Rounds

Emphasize Hospitalists to communicate with RN or AP when printing prescriptions

Hospitalists and Case Management/SWS to start processing medications that need preauthorization prior to the day of discharge

Bring awareness to Pharmacy & Hospitalist teams - to be cognizant of patients on Nebulizer and switch to inhaler upon discharge

Bring awareness to interdisciplinary team members of impact of PDFC data on their practice

Implications for Practice: Completion of the process related to medication upon discharges plays a vital role for improved patient outcomes, can reduce both return visits to the Emergency Department and readmission rates and can maintain higher standards of clinical practice and service excellence, thereby promoting a culture of patient safety. Future plans include: pharmacy and nursing verifying accuracy of patient’s preferred pharmacy during daily rounds, pharmacy tracking and reviewing specific medication cases, Case Management/Social Work Services (SWS) assisting in following-up on medications that need preauthorization and the data being presented at Nursing Operations and Hospitalist Meetings.